You should probably carry a first aid kit

In the context of alpine outing of up to 3 days 

For the sake of debate I ll make the case for NOT carrying a first aid kit.
Well, to be honest I do carry a minimalist « care package » consisting of:
Lip balm
Sunscreen
Sam split
Plasters
Climbing tape
Second skin pieces
Ortovox emergency bivvy

If your medical training is minimal I don’t think you need more because you will always be in one of those 4 scenarios if shit hit the fan:

1/ what you/your partner have can be treated with what you have and you can keep going (blisters, cuts, sunburn etc…)

2/ what happened cannot be treated with what you have but if you soldier on you can get out of the situation (spread ankle, rock that hit your hand, cut to the face, fainting…)

3/ what happened is too serious for you to fully handle anyway and then a better équipement would be a phone or a sat com unit (serious trauma, broken bones, falling hard …)

4/ it was your day and your are dead or close to it and no extra tourniquet, pills or cream would have helped you anyway (huge crevasse fall with no rope, landslide, avalanches, crushed limbs…)

At least that is how I see it.

Ps: Of course I ll make exceptions if going with beginners, kids or a larger group.  

No one has mentioned Benadryl yet for overnight trips.  This med is super useful for stings/rashes/other non life threatening things that will ruin a trip. Also, added bonus that it could help in anaphylaxis when you run out of the epi you may or may not have.

In addition, anytime I’m car camping I carry Narcan. This is a common, easy way to save a life that requires no training.

Finally, amen to whoever said tweezers.  Those things are impossible to improvise and so so useful.

PS lol do not be stressed about making an arterial bleed sterile.

Now I know why people are carrying those huge packs for a 4 pitch-er.

I don't know who's kit this came from.  24 hours prior to this photo, I didn't even know my own name or where I was. 

A splint could have been helpful, and maybe cutting up a shirt to fashion a better sling.  But, this stuff got the job done.  Keep in mind that this is right after the gauze pads had been changed out for clean, new ones; and, the arm had been washed up a bit.

I am glad, however, that nobody had a tourniquet, because it might have gotten used.

Oh, and a hat isn't a bad idea if you have a head injury.  The doctors diagnosed frostbite on my ear.  I mean, how in hell?  But, I guess if there's a lot of trauma like that, thermal injuries are super easy bonus points.

[The two gentlemen who initially came to my aid probably saved my life.  They were complete strangers.  But, to this day, we keep in touch, and I might have to swing by later this summer to say hi again.]

Jason ELwrote:

I don't know who's kit this came from.  24 hours prior to this photo, I didn't even know my own name or where I was. 

A splint could have been helpful, and maybe cutting up a shirt to fashion a better sling.  But, this stuff got the job done.  Keep in mind that this is right after the gauze pads had been changed out for clean, new ones; and, the arm had been washed up a bit.

I am glad, however, that nobody had a tourniquet, because it might have gotten used.

Oh, and a hat isn't a bad idea if you have a head injury.  The doctors diagnosed frostbite on my ear.  I mean, how in hell?  But, I guess if there's a lot of trauma like that, thermal injuries are super easy bonus points.

[The two gentlemen who initially came to my aid probably saved my life.  They were complete strangers.  But, to this day, we keep in touch, and I might have to swing by later this summer to say hi again.]

You’ve got my attention, and I enjoy a good accident story as much as anyone. What caused that arm injury? 

Cronwrote:

You’ve got my attention, and I enjoy a good accident story as much as anyone. What caused that arm injury? 

Nothing exciting.  I was just in the boulder field ferrying loads when it happened.  I can't say for certain what happened because I have no memory of it.  The guys that found me said it looked like the part of the snowfield gave way and I dropped about 20 feet between some boulders.  But, I think it could have been something as simple as being fatigued, inattentive and losing my balance.  I had suffered significant nerve damage a few months prior, and was still trying to adjust to things.

Of course, it took me a fair spell to remember the whole stroke thing.  Which was a relief, because it meant that this fall hadn't quite fucked me up as badly as we had first though.  Turns out, I was already deaf on my right side, anyway.  So, things were looking up.

Well, I guess all you can do is look up when you are lying on your back on a pile of boulders.

It's a weird feeling lying on your back, looking up at some snow and a huge granite precipice ... and realizing you don't even know your own name ... I thought we had fallen off the climb, because the only memory I had were scattered recollection fragments of a rockfall incident on Elephants Perch a couple weeks prior.  But, I did know that I didn't know who "we" were.  Just visions of sliding down a rope, uncontrollably, and seeing my partner's head covered in blood.  And, now I'm on my back, looking up at this big cliff. 

Jason ELwrote:

I am glad, however, that nobody had a tourniquet, because it might have gotten used.

I wonder if I could put a "DNT" tattoo on each limb - DO NOT TOURNIQUET. 

Ryan Never climbs wrote:

Is that a Budweiser shirt?!

A college knock off of a Budweiser shirt.  Copyright infringement, I'm sure.  Sweet shirt, though.  It was a knock off of that add with the three chicks in white one-piece swimsuits, if you can recall those ads.  It's in a red plastic biohazard bag in the Lander landfill, if you want it.  Like I said, it's a sweet shirt.  Probably a size Large, so a good chance it'd fit.

Anna Janecekwrote:

No one has mentioned Benadryl yet for overnight trips.  This med is super useful for stings/rashes/other non life threatening things that will ruin a trip. Also, added bonus that it could help in anaphylaxis when you run out of the epi you may or may not have.

In addition, anytime I’m car camping I carry Narcan. This is a common, easy way to save a life that requires no training.

Finally, amen to whoever said tweezers.  Those things are impossible to improvise and so so useful.

PS lol do not be stressed about making an arterial bleed sterile.

Narcan?   Remind me not to go car camping where you go car camping.  Sounds pretty rowdy. 

Some white tape, neosporin, super glue, ibuprofen, small sharp knife, and some pain killers is all I take, front country or back. I'm no wilderness first responder and I have no intention of becoming one.

Regarding a CPR mask, I agree that CPR is highly unlikely to change the outcome for an arrest due to trauma in the backcountry.  And I am skeptical about it for an arrest due to a pre-existing heart condition.  But CPR can be highly effective for electrocutions, i.e. lightning victims.  Most lightning deaths are due to cardiac arrest, not burns.

"Unlike triage in common multicasualty situations, with lightning, anyone who shows signs of life such as moaning or groaning will survive, albeit perhaps with sequelae, and may be attended to later . Because the only cause of immediate death is CPA, the goal of treating lightning strike victims is to resuscitate and stabilize those in arrest" - eknygos.lsmuni.lt/springer/…

A friend knew a couple hit by lightning while camping in a tent at 7k feet.  She was blinded.  He went into respiratory arrest.  She gave him CPR and then he guided her back to the car.

Keychain CPR masks are not much weight.

Steve Waltmanwrote:

Regarding a CPR mask, I agree that CPR is highly unlikely to change the outcome for an arrest due to trauma in the backcountry.  And I am skeptical about it for an arrest due to a pre-existing heart condition.  But CPR can be highly effective for electrocutions, i.e. lightning victims.  Most lightning deaths are due to cardiac arrest, not burns.

"Unlike triage in common multicasualty situations, with lightning, anyone who shows signs of life such as moaning or groaning will survive, albeit perhaps with sequelae, and may be attended to later . Because the only cause of immediate death is CPA, the goal of treating lightning strike victims is to resuscitate and stabilize those in arrest" - eknygos.lsmuni.lt/springer/…

A friend knew a couple hit by lightning while camping in a tent at 7k feet.  She was blinded.  He went into respiratory arrest.  She gave him CPR and then he guided her back to the car.

Keychain CPR masks are not much weight.

i think the point is, a lot of recent research shows that compression only CPR is just as effective. No need for the layperson to carry a mask anymore.

https://www.ahajournals.org/doi/full/10.1161/circulationaha.107.189380

curt86irocwrote:

i think the point is, a lot of recent research shows that compression only CPR is just as effective. No need for the layperson to carry a mask anymore.

https://www.ahajournals.org/doi/full/10.1161/circulationaha.107.189380

In the linked journal article, the benefits of CPR rescue breaths (30:2 compressions:breaths) are acknowledged for some situations, such as asphyxia, drowning, infants, etc, and administration by a lay person trained in CPR. Without breaths, oxygen saturation diminishes in the tissues more quickly. 

keep in mind there may be other benefits to not performing rescue breathes on a stranger. from the article:

Eliminating the expectation of mouth-to-mouth contact during CPR is likely to improve esthetics and address the expressed concern of potential bystanders about infection. Simplifying CPR training also improves trainees’ ability to learn and perform, among other things, proper chest compressions (LOE 6**).47 Finally, eliminating ventilation instructions in dispatcher-assisted CPR reduces the time required to commence compressions, as observed in simulated (LOE 6*,**)48,49 and actual out-of-hospital resuscitations (LOE 2*).21

curt86irocwrote:

keep in mind there may be other benefits to not performing rescue breathes on a stranger. from the article:

Eliminating the expectation of mouth-to-mouth contact during CPR is likely to improve esthetics and address the expressed concern of potential bystanders about infection. Simplifying CPR training also improves trainees’ ability to learn and perform, among other things, proper chest compressions (LOE 6**).47 Finally, eliminating ventilation instructions in dispatcher-assisted CPR reduces the time required to commence compressions, as observed in simulated (LOE 6*,**)48,49 and actual out-of-hospital resuscitations (LOE 2*).21

 

That’s what a CPR mask is for. 

no, let me clarify...

the entire point of the article is if you are a layperson, do compression only CPR. if you are a trained rescuer, maybe do traditional CPR. something is better than nothing, and the medical community would rather you pump on someone's chest than fumble with a mask because compressions are more important in the majority of cardiac arrests.

i will also tell you, as a medical provider, i'm not giving you rescue breathes in this day and age even with a mask.... you're getting compressions until the bag gets there...

curt86irocwrote:

no, let me clarify...

the entire point of the article is if you are a layperson, do compression only CPR. if you are a trained rescuer, maybe do traditional CPR. something is better than nothing, and the medical community would rather you pump on someone's chest than fumble with a mask because compressions are more important in the majority of cardiac arrests.

i will also tell you, as a medical provider, i'm not giving you rescue breathes in this day and age even with a mask.... you're getting compressions until the bag gets there...

I agree with that concern when dealing with strangers. If the victim is a good friend or loved one, I’m pulling out all the stops. 

Though if I need to do CPR on my wife surely a mask has zero benefit since I'm not worried about catching something from her, right?

Cornelius Yukon wrote:

You can be glad no one had one, because you didn't need one.

If you NEED a tourniquet, a tourniquet is the only thing that will save your life; however, I see this being extremely improbable in climbing.

That night, they were discussing amongst themselves whether I would make it to the morning.  They were concerned about the bleeding.  Whether they thought it would be the bleeding or the head trauma that ended me, I don't know.  But, I do know that all three had doubts about whether I'd make it to through the night.

Not that I want people to carry more stuff for the sake of carrying more stuff, but

a small bottle of liquid tears can be very useful

This would obviously be something for a basecamp or trunk-of-the-car kit, rather than to bring on a climb.  It's a niche product, yes, but it someone needs it, it can make a tremendous difference.